Provider Demographics
NPI:1215268875
Name:ARNOLD, ROY MASON (MD)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:MASON
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 N CROSS POINTE BLVD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47715-4010
Mailing Address - Country:US
Mailing Address - Phone:812-402-2003
Mailing Address - Fax:
Practice Address - Street 1:525 AUDUBON DR
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47715-3605
Practice Address - Country:US
Practice Address - Phone:812-746-9945
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2013-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01062684A207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ININ1257001OtherINDIVIDUAL PTAN